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Preauthorization requirements suspended as part of 'surge and flex'

Cuomo announced the state is directing insurers to suspend certain hospital requirements as part of the state's 'surge and flex' COVID-19 response in hospitals.

Gov. Andrew Cuomo announced on Wednesday that the Department of Financial Services has directed insurers to suspend requirements, such as preauthorization, during COVID-19.

This move comes as part of the state's "surge and flex" protocol for combatting the virus' impact on hospitals. The suspension will last 60 days.

Hospitals will now be able to quickly transfer patients between hospitals or discharge patients who are ready to go to a different care facility or their homes, according to Cuomo's office. 

Governor Cuomo said Wednesday "this new guidance will help streamline hospitals' ability to quickly transfer patients between facilities, increase bed capacity and balance patient load."

A similar move was made back in the spring during the first COVID-19 surge in New York.

"A temporary suspension of preauthorization and other administrative requirements provides necessary flexibility for hospitals during this critical time to maintain sufficient hospital bed capacity," Department of Financial Services Superintendent Linda A. Lacewell said.

Some of the requirements that will be suspended include:

  • "Preauthorization review for urgent or non-elective scheduled inpatient surgeries, hospital admissions and transfers between hospitals;
  • "Preauthorization review for inpatient rehabilitation and home health care services following an inpatient hospital admission; and
  • "Preauthorization review for inpatient mental health services following an inpatient hospital admission."

"As we work to implement Governor Cuomo's Winter Plan, these regulatory changes will help keep hospital space available for everyone who needs it and speed the delivery of services," New York State Department of Health Commissioner Dr. Howard Zucker said.

"Though New Yorkers have done a great job slowing the spread, COVID-19 continues to be a threat, and it is essential that patients get the care they need as quickly as possible," Zucker added.

You can read the full letter sent to insurers here.

  

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